Courtney Noel

Individual provider Active NPI Athletic Trainer · Cottage Grove, WI

NPI 1689041972 · NPPES record last updated Aug 21, 2015

Key facts

NPI
1689041972
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
License
1379 (WI)
Practice address
308 W Clover LN
Cottage Grove, WI 53527-9428
Phone
(608) 220-9326
NPI assigned
Aug 21, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1379WIMDOptometrist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1379 WI Yes

Addresses

Primary practice location

308 W Clover LN
Cottage Grove, WI 53527-9428

Mailing address

308 W Clover LN
Cottage Grove, WI 53527-9428

Other providers in Cottage Grove, WI

All providers in Cottage Grove, WI · Athletic Trainer in Wisconsin

Sources for this page

Verify at the official NPI Registry.